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Does Ultrasound Correlate with Surgical or Histologic Findings in Greater Trochanteric Pain Syndrome? A Pilot Study

Fearon, Angela; Scarvell, Jennie; Cook, Jill; Smith, Paul

Description

Background Greater trochanteric pain syndrome can be severely debilitating. Ideal imaging modalities are not established, treatments are not reliably evaluated, and the underlying pathology is not well understood. Questions/purposes Using surgical and histopathology findings as a gold standard, we therefore determined the positive predictive value of preoperative ultrasound assessment for greater trochanteric pain syndrome recalcitrant to nonoperative management. In addition, we report the...[Show more]

dc.contributor.authorFearon, Angela
dc.contributor.authorScarvell, Jennie
dc.contributor.authorCook, Jill
dc.contributor.authorSmith, Paul
dc.date.accessioned2015-12-08T22:43:50Z
dc.identifier.issn0009-921X
dc.identifier.urihttp://hdl.handle.net/1885/37376
dc.description.abstractBackground Greater trochanteric pain syndrome can be severely debilitating. Ideal imaging modalities are not established, treatments are not reliably evaluated, and the underlying pathology is not well understood. Questions/purposes Using surgical and histopathology findings as a gold standard, we therefore determined the positive predictive value of preoperative ultrasound assessment for greater trochanteric pain syndrome recalcitrant to nonoperative management. In addition, we report the outcomes of gluteal tendon reconstructive surgery using validated clinical and functional outcome tools and evaluate the contribution of the tendon and bursa to greater trochanteric pain syndrome. Patients and Methods We reviewed 24 patients who had combined gluteal tendon reconstruction and bursectomy. Preoperative ultrasound imaging was compared with surgical findings. In the absence of a greater trochanteric pain syndrome specific outcome tool, surgical outcomes for pain and function were assessed via a 100-mm visual analog scale, the modified Harris hip score, and the Oswestry Disability Index. Strength also was measured. The tendon and bursa tissue collected at surgery was histopathologically reviewed. Results In our small study, ultrasound had a high positive predictive value for gluteal tendon tears (positive predictive value = 1.0). Patients reported high levels of pain relief and function after surgery; tendon and bursa showed pathologic changes. Conclusions Ultrasound appears to be clinically useful in greater trochanteric pain syndrome; reconstructive surgery seems to relieve pain and the histopathologic findings show tendinopathy and bursa pathology coexist in greater tro- chanteric pain syndrome. Level of Evidence Level IV, case series. See the Guidelines for Authors for a complete description of levels of evidence.
dc.publisherSpringer
dc.rightsCopyright Information: © The Association of Bone and Joint Surgeons 2009
dc.sourceClinical Orthopaedics and Related Research
dc.subjectKeywords: corticosteroid; adult; aged; article; bone pain; bursectomy; clinical article; controlled study; diagnostic value; echography; female; gold standard; greater trochanteric pain syndrome; histopathology; human; human tissue; intermethod comparison; physioth
dc.titleDoes Ultrasound Correlate with Surgical or Histologic Findings in Greater Trochanteric Pain Syndrome? A Pilot Study
dc.typeJournal article
local.description.notesImported from ARIES
local.identifier.citationvolume479
dc.date.issued2009
local.identifier.absfor110320 - Radiology and Organ Imaging
local.identifier.ariespublicationu4201517xPUB148
local.type.statusPublished Version
local.contributor.affiliationFearon, Angela, College of Medicine, Biology and Environment, ANU
local.contributor.affiliationScarvell, Jennie, College of Medicine, Biology and Environment, ANU
local.contributor.affiliationCook, Jill, Deakin University
local.contributor.affiliationSmith, Paul, College of Medicine, Biology and Environment, ANU
local.description.embargo2037-12-31
local.bibliographicCitation.startpage7
local.identifier.doi10.1007/s11999-009-1174-2
dc.date.updated2016-02-24T10:40:46Z
local.identifier.scopusID2-s2.0-77954012710
CollectionsANU Research Publications

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